title: Impact of body mass index and waist-to-hip ratio on clinical outcomes in patients with ST-segment elevation acute myocardial infarction (from the Korean Acute Myocardial Infarction Registry).
abstract: The relation between body mass index (BMI) and waist-to-hip ratio (WHR) to clinical outcomes in patients with ST-segment elevation acute myocardial infarction (MI) has not been well described. As part of the Korean Acute MI Registry, we enrolled 3,734 eligible patients who were diagnosed with ST-segment elevation acute MI. The study population was categorized by BMI (into 4 groups according to the World Health Organization classification for the Asian population) and WHR (into 2 sets of 4 groups, 1 set for men and another for women, based on the INTERHEART study). Baseline characteristics and clinical outcomes were analyzed and compared among the BMI and WHR categories. Mean follow-up duration was 199 +/- 37 days. In the BMI category, underweight versus obese patients were older, were more likely to present with heart failure, and underwent guideline-based treatments less frequently. In the WHR category, the reverse trends were apparent for the latter factors except treatment-use frequencies. The highest mortality rate was observed in patients with the lowest BMI and the highest WHR. In an adjusted model, the highest WHR (hazard ratio 5.57, 95% confidence interval 1.53 to 12.29, p = 0.009) and the underweight (hazard ratio 2.88, 95% confidence interval 1.17 to 6.08, p = 0.021) categories within the 2 anthropometric indexes remained as mortality risk factors. In conclusion, the relation between obesity and prognosis after ST-segment elevation acute MI appears complex and should be further assessed in larger population-based cohort studies to determine the associations apparent in this study.
authors.affiliation: Yeungnam University Hospital, Daegu, South Korea.
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Woong
authors.initials: W
authors.lastname: Kim
authors.forename: Dong-Gu
authors.initials: DG
authors.lastname: Shin
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong-Su
authors.initials: DS
authors.lastname: Kim
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.forename: Kyoo-Rok
authors.initials: KR
authors.lastname: Han
authors.forename: Chong-Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Myeong-Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Shung-Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D049629:Waist-Hip Ratio